Until 2013, the DSM (Diagnostic and Statistical Manual of Mental Disorders) incorporated a ‘bereavement clause’ into the criteria for major depressive disorder, excluding patients from a diagnosis of clinical depression if they suffered bereavement in the last two weeks. Put simply: if someone you love has just died and you cry all day and can’t eat and everything is terrible — well, that’s a healthy and expected response which we call ‘grief’. The removal of the clause by the American Psychiatric Association was contentious, with accusations made that psychiatrists were trying to ‘medicalise’ mourning. One commentator called it the most controversial decision since the removal of homosexuality from the list of psychiatric disorders in 1973.

For me, this illustrates a lot of pertinent questions about how we think and talk about mental illness. What does mental wellness look like? How do we draw the distinction between the normal fluctuations of a healthy mindset and ‘pathological’ functioning? Does having the authority to categorise what mental states are ‘normal’ give psychiatrists social and ideological influence beyond their remit?Continue Reading